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    <title>导乐陪伴分娩工作记录表</title>
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</head>
<body>
    <div class="header">
        <h1>导乐陪伴分娩工作记录表</h1>
    </div>
    
    <!-- 基本信息表格 -->
    <table>
        <tr>
            <td>产妇姓名：<input type="text"></td>
            <td>年龄：<input type="number"></td>
            <td>导乐师：<input type="text"></td>
        </tr>
        <tr>
            <td>宫口打开程度：<input type="number" style="width: 60px;"> cm</td>
            <td colspan="2">服务开始时间：<input type="text"></td>
        </tr>
    </table>
    
    <hr>
    
    <!-- 导乐前评估 -->
    <h2>导乐前评估（打勾）</h2>
    <table>
        <tr>
            <td>
                <div class="checkbox-group">
                    <div class="checkbox-item">产妇精神状态：</div>
                    <div class="checkbox-item"><input type="checkbox"> 疲倦</div>
                    <div class="checkbox-item"><input type="checkbox"> 抑郁</div>
                    <div class="checkbox-item"><input type="checkbox"> 焦虑</div>
                    <div class="checkbox-item"><input type="checkbox"> 暴躁</div>
                    <div class="checkbox-item"><input type="checkbox"> 紧张</div>
                </div>
            </td>
        </tr>
        <tr>
            <td>
                <div class="checkbox-group">
                    <div class="checkbox-item"><input type="checkbox"> 初产妇</div>
                    <div class="checkbox-item"><input type="checkbox"> 经产妇</div>
                    <div class="checkbox-item">第 <input type="number" style="width: 40px;"> 胎</div>
                </div>
            </td>
        </tr>
        <tr>
            <td>
                <div class="checkbox-group">
                    <div class="checkbox-item">家属对导乐的态度：</div>
                    <div class="checkbox-item"><input type="checkbox"> 支持</div>
                    <div class="checkbox-item"><input type="checkbox"> 不支持</div>
                </div>
            </td>
        </tr>
    </table>
    
    <hr>
    
    <!-- 服务内容表格 -->
    <h2>服务内容</h2>
    <table class="service-table">
        <tr>
            <th>项目</th>
            <th>参考时间</th>
            <th>操作次数</th>
        </tr>
        <tr>
            <td colspan="3" class="section-title">非药物镇痛</td>
        </tr>
        <tr>
            <td>按摩头部</td>
            <td>15-30分钟/次</td>
            <td><input type="number"></td>
        </tr>
        <tr>
            <td>按摩肩部</td>
            <td>15-30分钟/次</td>
            <td><input type="number"></td>
        </tr>
        <tr>
            <td>按摩背部</td>
            <td>15-30分钟/次</td>
            <td><input type="number"></td>
        </tr>
        <tr>
            <td>按摩腰部</td>
            <td>15-30分钟/次</td>
            <td><input type="number"></td>
        </tr>
        <tr>
            <td>按摩腿部</td>
            <td>15-30分钟/次</td>
            <td><input type="number"></td>
        </tr>
        <tr>
            <td>水疗</td>
            <td>20分钟/次</td>
            <td><input type="number"></td>
        </tr>
        <tr>
            <td>黄豆袋热敷</td>
            <td>15分钟/次</td>
            <td><input type="number"></td>
        </tr>
        <tr>
            <td>呼吸减痛</td>
            <td>每次宫颈起止</td>
            <td><input type="number"></td>
        </tr>
        <tr>
            <td>音乐镇痛</td>
            <td>依产妇需求</td>
            <td><input type="number"></td>
        </tr>
        <tr>
            <td>香薰疗法</td>
            <td>依产妇需求</td>
            <td><input type="number"></td>
        </tr>
    </table>
    
    <hr>
    
    <!-- 体位管理表格 -->
    <h2>体位管理</h2>
    <table class="position-table">
        <tr>
            <th>体位</th>
            <th>参考时间</th>
            <th>操作次数</th>
        </tr>
        <tr>
            <td>站立/散步/曼舞</td>
            <td>15-20分钟/次</td>
            <td><input type="number"></td>
        </tr>
        <tr>
            <td>蹲</td>
            <td>15-20分钟/次</td>
            <td><input type="number"></td>
        </tr>
        <tr>
            <td>分娩球</td>
            <td>15-20分钟/次</td>
            <td><input type="number"></td>
        </tr>
        <tr>
            <td>同侧侧卧位</td>
            <td>15-20分钟/次</td>
            <td><input type="number"></td>
        </tr>
        <tr>
            <td>同侧侧俯卧位</td>
            <td>15-20分钟/次</td>
            <td><input type="number"></td>
        </tr>
        <tr>
            <td>开放式膝胸卧位</td>
            <td>15-20分钟/次</td>
            <td><input type="number"></td>
        </tr>
        <tr>
            <td>支撑蹲位</td>
            <td>15-20分钟/次</td>
            <td><input type="number"></td>
        </tr>
        <tr>
            <td>不对称位</td>
            <td>15-20分钟/次</td>
            <td><input type="number"></td>
        </tr>
        <tr>
            <td>前倾位（站立/跪式、坐）</td>
            <td>15-20分钟/次</td>
            <td><input type="number"></td>
        </tr>
        <tr>
            <td>手膝位</td>
            <td>15-20分钟/次</td>
            <td><input type="number"></td>
        </tr>
    </table>
    
    <div class="footer">
        <p>导乐陪伴分娩工作记录表 &copy; 医疗记录系统</p>
    </div>
</body>
</html>